Among Friends

A former colleague and friend that I had known for many years was found to be anemic on a recent blood profile shortly after his 80th birthday. He had been feeling fine so he wasn’t particularly worried until the bone marrow result came back showing acute myelocytic leukemia. After the initial blow of receiving that diagnosis, he then had a very tough decision to make. He had never been a strong proponent of chemotherapy especially in older patients, and he would have surely declined it for himself as well. However, his wife was ill and he wanted to be around to help her through her difficult time. He had always been fairly healthy before now. So he decided to go for it. He really felt that he didn’t have much choice.

The first few weeks into his chemotherapy, he seemed to do fairly well. One day, he began to notice blotchy patches of redness and discomfort in his skin. Within a few short days from that point, his skin was sloughing over 80% of his body. The dermatologist had diagnosed toxic epidermal necrolysis probably caused by an allergic reaction to one of the chemotherapeutic agents he had received. The pain was absolutely unbearable even though we used the strongest analgesics we could without suppressing his respiration. Multiple consultants assisted with his care all to no avail. It was suggested that we send him to a burn unit at the larger hospital downtown since we didn’t have one. This was brought up to him several times. Each time he declined saying “No, I really don’t want to go there. Even if it means I might die, I’d rather stay here with my friends.” We all did the best we could, but he ultimately died from overwhelming sepsis and renal failure. His family, who had been there for him every minute of his ordeal, was very gracious and thanked us for all that we had done.

Even if he had decided to go to the burn unit at the other hospital, I don’t know that it would have made any difference. However, his faith and his trust in us, his physicians, and the presence of his family and friends around him, hopefully gave him some strength to endure the severity of his misery at the end. At least he knew he was among those who loved him, and maybe, despite his physical suffering, that wasn’t a bad way to go. It could have been worse.